Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
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Review Meta Analysis
Healthcare-associated pneumonia does not accurately identify potentially resistant pathogens: a systematic review and meta-analysis.
The 2005 American Thoracic Society/Infectious Diseases Society of America guidelines introduced a concept of healthcare-associated pneumonia (HCAP) to define patients at higher risk of antibiotic-resistant pathogens, thus requiring broad spectrum therapy. There has been no systematic evaluation of the ability of this definition to identify antibiotic-resistant pathogens. ⋯ The HCAP concept is based on predominantly low-quality evidence and does not accurately identify resistant pathogens. Mortality in HCAP does not appear to be due to a higher frequency of resistant pathogens.
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The Centers for Disease Control and Prevention is pursuing 3 distinct, complementary efforts focused on providing data for action, including facility-level use metrics for benchmarking across comparable patient care settings, national estimates of usage patterns using sentinel surveillance sites, and limited assessments using proprietary data.